Human Animal interface patients Form 2a Eligibility Checklist

United States and Global Human Influenza Surveillance in at-Risk Settings (NIAID)

OMB: 0925-0737

IC ID: 218279

Information Collection (IC) Details

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Human Animal interface patients Form 2a Eligibility Checklist
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 11 Attachment 4 Form 2a Eligibility Checklist Attachment 4 -Form2a Eligibility Checklist.pdf No   Fillable Fileable

Health Health Care Services

 

900 0
   
Individuals or Households
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 900 0 900 0 0 0
Annual IC Time Burden (Hours) 150 0 150 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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